When you are caring for a loved one with a disability or illness, it’s easy to become overwhelmed. Caregivers often spend so much time helping their loved one – whether an aging parent, a disabled child or even an ill spouse – that they don’t have the time to take care of themselves, even if that’s just taking a few hours to relax and recharge. Without that time, caregivers can become frustrated, burned out or even angry, and it has a detrimental effect on their health as well as the well-being of their loved one. Respite care is designed to give caregivers a temporary break from their responsibilities while still ensuring that the ill loved one is being cared for and isn’t in danger.
Respite Care Defined
Respite workers provide short-term relief for primary caregivers of disabled or chronically ill individuals. For instance, you might be caring for a parent with dementia who cannot be left alone. You might want to run errands or have lunch with a friend, but taking your parent along can cause them to become disoriented or upset, and your attention will be focused on him or her rather than your lunch date. With respite care, a trained professional will take over the care of your parent for a few hours or most of the day, allowing you to get away without worry.
Respite care is offered in homes, as well as at healthcare facilities and care establishments known as adult daycare. An adult daycare is different than a senior center in that it provides more supervision and assistance, as well as monitoring and help with healthcare needs, whereas a senior center runs activities and events designed for older adults who are independent and able-bodied. An adult daycare allows caregivers to work or take care of their own responsibilities, while ensuring that their loved one is safe, engaged and receiving the healthcare (such as medication assistance or monitoring) that's necessary.
Job Description of a Respite Worker
A respite worker provides these services. Depending on where they work, responsibilities may vary, but most are charged with providing assistance and support to elderly or disabled individuals.
A respite worker employed by an adult daycare or respite center is primarily involved with providing assistance with such things as getting around, using the bathroom, hygiene, feeding and administering medications. In some cases, they may be called upon to check vital signs like blood pressure or temperature. A center-based respite worker also helps plan and supervise activities and socializing with the patients.
A home-based respite worker provides similar services, but might also provide additional assistance with cooking, light housekeeping, transportation and other daily living activities. Some respite workers will bring their charges to doctor’s appointments, for instance, or on outings to local parks, museums or social gatherings. A big part of a home respite worker’s responsibilities is to offer companionship for patients, who may not otherwise have much opportunity for socializing and engagement. This might include playing games, reading out loud or simply having a conversation.
Regardless of where they work, respite workers have a responsibility to ensure the safety of their patients and for helping to manage potentially challenging behaviors. Those working with children with autism spectrum disorders, for instance, may be faced with specific behavioral challenges including violence. Respite workers must be prepared to handle these challenges and calm their patients when they become agitated.
Education Requirements for a Respite Worker
Generally speaking, there aren’t any specific education requirements for a respite worker, although many employers prefer candidates who have a high school diploma. Experience working with the populations served by the respite care agency is also desirable, but many employers offer on-the-job training. In some cases, in particular when the respite care plan requires medical intervention, the agency may require workers to hold the Certified Home Health Aide (CHHA) credential. Agencies that are reimbursed by Medicare or Medicaid for respite services typically must hire individuals that have completed specific training courses and passed a competency exam, while some states also require respite workers to have completed formal training programs. These programs are often provided by employers, but community colleges, vocational schools and community agencies also offer training. These training programs tend to focus on providing hygiene assistance, taking and recording vital signs, nutrition and infection control.
Beyond the education and training requirements, respite workers typically have to pass a background check. In addition, CPR and first aid certification is usually required, as is reliable transportation.
Salary and Experience
Despite offering an important and valuable service, respite workers earn a comparatively low salary. Most are paid about $10.77 per hour, which works out to a median annual salary of $26,400. This means that 50 percent of respite workers earn more, and 50 percent earn less. The highest paid people in this field earn above $47,000 per year, but most earn between $18,000 and $34,000 per year.
The fact that home health care, which includes respite care, is one of the lowest paying industries in the U.S. is a cause for concern for many industry groups and advocacy organizations. Several factors contribute to the low pay rates, including reimbursement rates from Medicare and Medicaid, which don’t allow agencies to pay higher wages and still maintain a healthy profit margin. In addition, these jobs are often seen as entry-level or unskilled, despite the training and level of skill required, and therefore pay less by default.
Home health care, including respite care, is the fastest growing field in the U.S., with the Bureau of Labor Statistics predicting a 41 percent increase in demand between now and 2026. Much of this demand is attributable to changes in expectations for aging. More adults want to “age in place,” meaning they wish to remain in their homes as long as possible, rather than move into a long-term care facility. As more people remain at home and rely on family members for care, the need for respite services is likely to skyrocket as millions of Americans reach retirement age and beyond.
Despite the number of job opportunities, though (expected to be more than 1 million by 2026) there is extremely high turnover in the field. On average, the home health industry sees about 60 percent turnover every year, and a startling majority of home health workers are living at or below the poverty level. Because respite workers are paid hourly and aren’t always full-time employees, their earnings tend to be low. Further contributing to the low earning potential is the fact that the majority – nearly 90 percent – of home health and respite workers are women, in particular women of color, who historically get paid significantly less than others.
There is a growing trend, though, to offer better opportunities in this field. Some agencies have started offering employee ownership opportunities and increasing education benefits to improve advancement opportunities. Not only does this benefit the workers, but the agencies themselves, which have lower turnover rates as a result of these benefits.
Qualities of a Good Respite Worker
Respite care can be challenging, and it’s not a good fit for everyone. While respite care agencies look for individuals who have the required education and training, there are also some personal characteristics that are important.
First, respite workers need to have patience – and a lot of it. Helping the elderly or disabled can be challenging, and they may not always move or follow instructions as well as you would like them to. Many have communication challenges as well, meaning you need to be willing to pay full attention and learn to interpret nonverbal cues. Understanding that things may not always go as planned, and that you will have good and bad days, can help you remain patient and provide good care.
Second, you must be dependable and trustworthy. Your patients and their caregivers are relying on you, and if you’re late to your appointments or cancel them, you can cause frustration or worse. Some individuals with cognitive disabilities need set routines, for instance, and suddenly changing plans can cause severe anxiety or upset. Your clients need to know that they can rely on you to be there when you say you will, and that you’ll follow through on your responsibilities. In addition, you need to be trustworthy, as your clients are inviting you into their homes and entrusting you with their loved one. Even if you work in a respite center, caregivers need to trust that you’re going to provide their loved one with the appropriate level of care, and that they will be safe and happy under your care.
Compassion and understanding are also important traits for a respite worker. Your clients are people, and deserve to be treated with dignity and compassion no matter what happens to them physically. It can be embarrassing and frustrating for many elderly people when they can’t do things they once did, or if things happen to their bodies that they can’t control – and it’s up to you to handle these incidents with compassion and discretion. Understanding what your patients are living with by doing your own research or seeking training can be invaluable to developing the empathy required to provide quality respite care.
Is Respite the Same as Hospice?
One common misconception is that respite care is the same as hospice care. However, they are very different. Hospice care is a means of managing and alleviating the symptoms of a terminally ill patient, and may be provided at home or in a hospital. Respite care is a short-term break for caregivers. Patients in a hospice setting might receive respite care to as a means to support their family and caregivers, but respite is also offered to non-terminal patients and caregivers. For example, a child with a cognitive disorder might get respite services so his or her parents can take a break.
What to Expect When Working as a Respite Worker
The first thing you will learn as a respite worker is that there is no such thing as a typical client or day. You might have “easy” days when everything goes according to plan, or you could have challenges, as when a client is agitated and has trouble expressing himself, meaning all of your plans are changed.
Depending on who you are working for and how long the respite session is (it might be a few hours, or it could be overnight) your daily schedule will vary. Usually you will have a meeting with the primary caregiver and the patient beforehand to discuss expectations, preferences and needs, and you may receive a written schedule for the session from your employer or the caregiver when you arrive. Usually, the respite provider will take notes, documenting activities, the patient’s mood, when he or she ate, used the toilet and any other important information. Sometimes, respite care might just mean watching a movie together, while other sessions could be more involved.
Above all, a respite worker needs to expect the unexpected, and be willing to build a relationship with clients. Many respite workers find that their clients become like family to them, and they become attached as their friendship grows. Most workers say that they don’t do the work because they will get rich, but rather because they love people and want to make a difference in others’ lives. In fact, some respite workers actually work on a volunteer basis simply because they find the work fulfilling. In either case, respite work is best for individuals who are caring, compassionate and want to help others.